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The Origin And Nature Of Our Institutional Models
To this day, staffing is a dilemma in both rural and urban locations. Recruiting for nonprofessional personnel is usually easier in rural locations unacceptable to many professionals. Professionals are easier to attract into urban locations, but there, nonprofessional turnover may run 50 percent a year, even with relatively good salaries (e.g., Jaslow, Kime and Green, 1966). The very heterogeneity of residents, desired by many workers in the field, has presented a major problem in staffing because so many different skills and types of training are needed to serve a group with a tremendous variety of problems (Jaslow, Kime and Green, 1966).
6. From the beginning, and ever since, the research potential of institutions has been exalted (e.g., Seguin, 1870; Kerlin, 1885; Sprattling, 1903; Johnson, 1904; Schlapp, 1915), and one of the arguments for congregating large numbers of residents had been that this would facilitate research. This potential has never been fulfilled except at a very few institutions at a given time. Even today, with over 150 institutions, less than a half-dozen can be said to be making a well-sustained, active, and significant research contribution to the field.
7. One goal was often achieved by institutions: providing relief to families. But even here we have an element of irony in that family relief could often have been achieved better and cheaper by other measures than institutionalization.
If my formulations and interpretations are correct, we can summarize the trends in United States residential care for the retarded as follows, and as depicted in Figure 1. Attitudes toward retardates paralleled those toward a number of other deviancies. Around 1850, a developmentally oriented residential model attempted to return the deviant to the community. Between 1870 and 1890, this model was replaced with one based on pity which called for protective isolation of the retardate. This period was brief, and was soon succeeded by one emphasizing the menacing nature of deviancy. Certain trends that had originated during the pity period were accentuated, so that retardates were congregated into huge groups, sequestrated from society, segregated from other retardates of the opposite sex, asexualized, and dehumanized in poorly supported, inhumanely run regimented institutions. The puzzling and anachronistic mode of functioning of today's institutions can be understood if we see them as having been maintained by a tremendous amount of momentum but bereft of rationales for about 40 years.
I submit that the problem of residential services cannot be solved by working on a number of specifics at a time, or by calling for simple-minded, low-level measures such as more money. All the money in the world will not change the minds of men. What we need is concepts and models. The current model, the entire system, as Howe called it, is inconsistent with contemporary cultural values and scientific knowledge. We need a model of services that is appropriate to knowledge, resources, and needs of the 1970's and beyond, and that is based on a contemporary perception of the nature and role of the retarded person in our society. Such new and viable ideology, presented in the next sections of this monograph, is gaining wide acceptance. With the acceptance of this new ideology, we are witnessing the agonized death struggle of an institutional model based on a perception of the retardate as a menace and/or subhuman organism.
The greatest irony lies in the fact that the founding fathers foresaw much of what happened, and repudiated the trend institutions were taking within 20 years of their founding. H. B. Wilbur (1879) stated that he had always been in favor of building specialized institutions rather than enlarging existing ones for multiple purposes. In 1886, Howe gave the dedication speech for a new institution for the blind in Batavia, New York. The fact that he virtually repudiated this institution at its very beginning, and as the guest of honor, cannot be overemphasized, as it constituted an act of incredible courage and conviction. Everything he said applies to the institutions for the retarded as well:
"As it is with individuals, so it is with communities; and society moved by pity for some special form of suffering, hastens to build up establishments which sometimes increase the very evil which it wishes to lessen.
"There are several such already in this country; and unless we take heed there will be many more. Our people have rather a passion for public institutions, and when their attention is attracted to any suffering class, they make haste to organize one for its benefit.
"But instead of first carefully inquiring whether an institution is absolutely necessary, that is, whether there is no more natural and effectual manner of relieving the class; and afterwards, taking care that no vicious principle be incorporated into the establishment; they hastily build a great showy building, and gather within its walls a crowd of persons of like condition or infirmity; and organize a community where everything goes by clock-work and steam. If there be a vicious principle in the organization, as of closely associating persons who ought to live apart, it is forgotten in admiration of contrivances for making steam do what once was done by the good housewife, with her cook and maid; and of the big bright coppers, the garnish walls, and the white floors.